Major congenital malformations associated with ASMs

Data from several large national epilepsy in pregnancy databases has shown the valproate consistently demonstrates the greatest risk of congenital malformations associated with ASMs relative to other ASMs, although the risk with other ASMs, e.g., phenobarbital and topiramate is also high.¹ These data suggest that levetiracetam is associated with the lowest frequency of congenital malformations.¹

Reference:

1.Tomson T, Marson A, Boon P, et al. Valproate in the treatment of epilepsy in girls and women of childbearing potential. Epilepsia 2015; 56 (7): 1006‒1019.